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Bullous delayed pressure urticaria: pathogenic role for eosinophilic granulocytes?
1Department of Dermatology Venerology and Allerology, University of Würzburg, Germany.
The British Journal of Dermatology
|August 10, 2005
Summary
Bullous delayed pressure urticaria (DPU) is a rare condition. Eosinophils and T-cells, not mast cells, appear key in its pathogenesis, offering new treatment avenues.
Area of Science:
- Dermatology
- Immunology
Background:
- Bullous delayed pressure urticaria (DPU) is a rare variant of DPU.
- The pathogenic mechanism of DPU remains elusive, complicating treatment.
Observation:
- A 72-year-old male patient presented with DPU, chronic urticaria, and delayed urticarial dermographism.
- Pressure challenge induced deep weals with vesicles and bullae after 24 hours.
- Histology revealed intraepidermal bullae with eosinophils and a dense dermal infiltrate.
Findings:
- Eosinophil activation was indicated by extracellular eosinophil cationic protein deposition.
- Both CD4+ and CD8+ T lymphocytes were present and expressed interleukin 5.
- Mast cell numbers and morphology were unchanged.
Implications:
- Bullous DPU may represent a severe variant of DPU.
- Eosinophils, T-cell subsets, and mast cells may play effector roles.
- Understanding the cellular infiltrate and cytokine release could reveal pathogenic mechanisms for DPU.
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